Prevalence of and interest in unionization among staff pharmacists

Article Outline

• Abstract
• 1. Introduction
• 2. Methods
  • 2.1. Questionnaire design
  • 2.2. Survey administration
  • 2.3. Data analysis
• 3. Results
  • 3.1. Response
  • 3.2. Unionization rates/interest in joining a union
  • 3.3. Work activities and working conditions
  • 3.4. Compensation and benefits
  • 3.5. Demographics
  • 3.6. Multivariate analysis
• 4. Discussion
• 5. Conclusion
• Acknowledgments
• References
• Copyright

Abstract 

Background

Although the propensity for staff pharmacists to join a labor union has never been high, conditions in the profession and workplace have changed over the last decade. Some of these changes may result in staff pharmacists joining a labor union, as well as increased interest in staff pharmacists who are currently not union members to join.

Objectives

The objectives of this study were to (1) assess the degree of union membership among staff pharmacists in 6 states, (2) compare the practice settings, work activities and conditions, compensation, and demographic characteristics between union and nonunion staff pharmacists, (3) assess the level of interest in joining a union among nonunion staff pharmacists, and (4) compare the practice settings, work activities and working conditions, wages and benefits, and demographic characteristics between nonunion staff pharmacists interested in joining a union and nonunion staff pharmacists who were not interested in joining a union.

Methods

A biennial pharmacist compensation study was conducted in 6 states (Florida, Iowa, Illinois, Minnesota, Tennessee, Wisconsin) in late 2003. Randomly selected pharmacists were mailed a self-administered questionnaire asking about their practice setting, work activities and conditions, wages and benefits, and demographic characteristics. Respondents were also asked to indicate current membership in a union and, if not a member, their desire to unionize their workplace.

Results

Compensation and unionization data were provided by 2,180 respondents (27% usable response rate), of which 1,226 (56%) were staff pharmacists. Eight percent of the staff pharmacists were union members, whereas 18% of nonunion members would vote to unionize their workplace. There were few statistically significant differences between union and nonunion staff pharmacists regarding work activities, working conditions, and hourly wages. However, the benefits provided to union staff pharmacists differed from those provided to nonunion staff pharmacists in several ways. Union staff pharmacists were younger than their nonunion counterparts (40.9 vs 44.5 years, P=.01), yet had worked for their current employers a longer time (11.1 vs 7.3 years, P=.03). Nonunion staff pharmacists interested in joining a union differed from those who would not by practice location and setting, working conditions, and benefits.

Conclusions

Although the union membership rate among staff pharmacists is relatively low, there are geographic and practice areas where membership rates are higher. Differences in work activities, working conditions, wages, and benefits were noted between union and nonunion staff pharmacists as well as between those who would join a union and those who would not. These differences merit further investigation, especially with respect to evaluating the effectiveness of unions and identifying factors that may lead nonunionized staff pharmacists to join a union.

Keywords: Unionization, Staff pharmacists, Work activities, Working conditions, Compensation, Benefits

Back to Article Outline

1. Introduction 

Employee staff pharmacists in all practice settings are faced with a variety of issues that affect the quality of their worklife and their ability to practice. Concerns about increased prescription volume, staffing levels, working conditions, and automation may stress the relationship between employee pharmacists and their employers.¹, ², ³, ⁴ As a result of growth and consolidation within hospitals and community pharmacies, employee staff pharmacists have become increasingly removed from decisions that affect their practice.⁵, ⁶ If employee staff pharmacists are limited in their ability to deal with workplace and professional issues with their employers as individuals, they may consider taking collective action to better represent their interests.

Employees desiring collective representation of their interests to their employers generally do so by forming or joining a labor union. Traditionally, labor union representation among pharmacists has been thought to be low. Estimates suggest that the union density of pharmacists is about 6%.⁷ However, even less is known about the extent of union representation among staff pharmacists. According to DeBenedette, only 2 unions enroll pharmacists exclusively (Guild for Professional Pharmacists, National Pharmacists Association).⁸ These unions primarily represent community pharmacists and are known to have at least 3,000 members, focused in Illinois and California. A number of other unions are known to enroll pharmacists as members (Service Employees International Union, United Food and Commercial Workers Union, Engineers and Scientists of California, Hospital and Health Care Employees Union, American Federation of State, County and Municipal Employees, Teamsters). Given the number of unions that may include pharmacists as members and variations in how each union reports its membership data, it is difficult to determine actual numbers of staff pharmacists belonging to a union.

Interest in unionization among staff pharmacists is difficult to gauge. McHugh found that 11% of all pharmacists and 15% of staff pharmacists would definitely vote to unionize their workplace, with another 22% and 28%, respectively, indicating that they would probably vote to unionize.⁹ However, the number of these pharmacists who were already members of a union, and whether opinions about union membership varied between members and nonmembers, was not reported. McHugh and Bodah found that intention to support a union was positively associated with male sex, having prior experience with a union, living in a household with a union member, and the belief that a union would positively affect wages, benefits, and professionalism.¹⁰

Wilson et al stated that unionization among nurses depended to a great extent on how management addressed concerns regarding the conditions of their employment.¹¹ To gain a better understanding of staff pharmacist unionization, it is important to assess the characteristics of those who belong to a union and what they receive as a result of their membership.¹² One would expect that if a union effectively represents the interests of its members, unionized staff pharmacists will have working conditions and compensation that are equal to, if not better than, those of nonunionized staff pharmacists.

In addition to learning the prevalence and characteristics of unionized staff pharmacists, it is important to determine the level of interest among nonunion staff pharmacists in joining a union. The aforementioned changes in the profession and the workplace may result in nonunionized staff pharmacists considering union membership. It is also important to assess the characteristics of those who would join a union compared with those who would not. Differences in work activities, working conditions, wages, and benefits between these groups may help identify motivations for staff pharmacists to desire union representation.

The objectives of this study are to (1) assess the degree of union membership among staff pharmacists in 6 states, (2) compare the practice settings, work activities and working conditions, compensation, and demographic characteristics between union and nonunion staff pharmacists, (3) assess the level of interest in joining a union among nonunion staff pharmacists, and (4) compare the practice settings, work activities and working conditions, wages and benefits, and demographic characteristics between nonunion staff pharmacists interested in joining a union and nonunion staff pharmacists not interested in joining a union.

Back to Article Outline

2. Methods 

2.1. Questionnaire design 

A biennial, cross-sectional pharmacist compensation survey was conducted in 6 states (Florida, Iowa, Illinois, Minnesota, Tennessee, Wisconsin) in late 2003. A questionnaire was developed and pretested by researchers at colleges of pharmacy in each state in the summer of 2003. The questionnaire was similar to one used in a survey in 4 states (Iowa, Illinois, Minnesota, Wisconsin) in 2001, allowing comparison to the current workforce environment in these states and the ability to monitor changes in conditions over time.¹³ The 4-page self-administered questionnaire was designed to gather respondent demographic characteristics, practice activities, working conditions, hourly wages, and benefits. Two questions were added to the 2003 survey asking respondents (1) whether or not they belonged to a union and (2) whether they would vote to unionize their workplace if a unionization vote were held today. Respondents were provided a dichotomous response option (yes/no) to each question. The questionnaire was approved by the Institutional Review Board at each participating institution.

2.2. Survey administration 

Researchers in each state selected a random sample of 10% to 20% of all licensed pharmacists residing in their states, using mailing lists obtained from their respective boards of pharmacy. A cover letter, the survey instrument, and a postage-paid return envelope were mailed to 8,550 pharmacists in the 6 states between September and November 2003. Two hundred seventy-three surveys were returned as undeliverable, leaving a sample of 8,227 who were assumed to have received the questionnaire. Reminder postcards were mailed to nonrespondents 2 weeks after the initial mailing. One month after the initial mailing, a follow-up survey was mailed to those who had still not responded. Respondents were told that their responses were not anonymous, as tracking numbers were used to follow-up with nonrespondents. However, they were assured in a cover letter that their responses were confidential, and at no time would the results be reported in such a way that would reveal a respondent's identity. Respondents were provided no monetary or other incentives to participate.

2.3. Data analysis 

All returned questionnaires were entered into a database and analyzed using SPSS version 12.0.¹⁴ For the purpose of this analysis, the target population is employee staff pharmacists, since they would be considered “employees” under the National Labor Relations Act and protected in their right to engage in collective bargaining. Therefore, only data from respondents who indicated that their position was “staff pharmacist” were included in this analysis. Pharmacy owners, managers and directors, assistant managers and directors, and respondents who indicated their position as “other” were excluded, as were the responses of those who did not complete the compensation and unionization questions on the survey.

Frequency tables were developed and percentages calculated for all categorical variables. Means and standard deviations were calculated for all parametric data. To protect respondent confidentiality, means are only reported for subcategories with greater than 10 respondents. Chi-square, t test, and analysis-of-variance tests were used to make statistical comparisons between groups of respondents. Results that are reported to be statistically significant imply that a P <.05 occurred when the statistical analysis was performed.

Back to Article Outline

3. Results 

3.1. Response 

Compensation and unionization data were provided by 2,180 respondents (27% usable response rate). Usable response rates ranged from 12% in Florida to 51% in Iowa. Of those who provided usable responses, 1,226 (56%) classified themselves as staff pharmacists. The location and primary practice setting of the staff pharmacists in the sample are described in Table 1, Table 2, respectively.

Table 1. Response rate by state

Table 2. Response rate by primary employment setting

3.2. Unionization rates/interest in joining a union 

Overall, 8% of staff pharmacists reported that they were members of a union (n=103). Union activity among staff pharmacists was reported in every state, with the highest rates in Illinois (26%) and Minnesota (17%) and much lower rates in the other 4 states (Florida 2%, Iowa 2%, Tennessee 1%, and Wisconsin 2%). Ninety-one percent of union members resided in a large urban area (top 100 US Census Metropolitan Area) compared with only 56% of nonunion members. Chain (16%) and supermarket (16%) staff pharmacists were most likely to belong to a union. Six percent of staff pharmacists in hospital and “other” settings were union members, whereas very few pharmacists in mass merchandiser (2%) and independent (<1%) settings were in a union. In Illinois, 56% of chain staff pharmacists (38 of 68) and 49% of supermarket staff pharmacists (18 of 37) reported belonging to a union. In Minnesota, 33% of chain staff pharmacists (10 of 30) and 26% of hospital staff pharmacists (10 of 39) belonged to a union.

Of the 1,123 staff pharmacists not belonging to a union, 202 (18%) reported that if a union election were held tomorrow they would vote to unionize their workplace. Although nonunion staff pharmacists in all 6 states expressed interest in unionization, nonunion staff pharmacists in Florida (39%) were much more likely to vote to unionize their workplaces than nonunion staff pharmacists in the other states (Iowa 8%, Illinois 12%, Minnesota 10%, Tennessee 17%, and Wisconsin 14%) (P<.001). Staff pharmacists in chain (26%), mass merchandiser (21%), and supermarket (19%) settings were the most likely to vote to join a union, whereas staff pharmacists in independent pharmacies (14%), hospitals (15%), and “other” settings (15%) were the least interested.

In Florida, nonunion staff pharmacists in all practice areas expressed interest in voting to join a union. Fifty percent of Florida's responding mass merchandiser staff pharmacists (10 of 20), 46% of chain staff pharmacists (34 of 74), and 42% of supermarket staff pharmacists (10 of 24) indicated they would vote to unionize if given the opportunity. More than one-quarter of Florida's independent (28%, 7 of 25) and hospital (29%, 20 of 69) nonunion staff pharmacists would also vote to unionize.

3.3. Work activities and working conditions 

There were no statistically significant differences in work activities between unionized and nonunion staff pharmacists. Both groups spend approximately 50% of their workday on dispensing-related activities, 22% of their time in consultation with patients and health care professionals, and 5% of their time in “other” activities (eg, teaching, research). Nonunionized staff pharmacists report spending slightly more of their time in drug use management (15% vs 13%) and slightly less in business management (9% vs 10%), but neither difference was statistically significant.

Among nonunionized staff pharmacists, statistically significant differences in work activities were reported between those who would vote to unionize and those who would not. Those who would vote to join a union spend significantly more time in dispensing and business management and significantly less time in consultation than those who would not join a union (see Fig. 1).

• 
  • View Large Image
  • Download to PowerPoint

• Fig. 1. 

  Work activities among nonunionized staff pharmacists.

There were no statistically significant differences between union and nonunion staff pharmacists in terms of working conditions (hours worked per week, percent working full time [≥30h/wk], weeks worked per year) except that union members worked more hours of compensated overtime (P=.03). Nonunion staff pharmacists interested in joining a union reported working more hours per week (P=.01) and were more likely to work full time (P=.04) than those not interested in joining a union (see Table 3).

Table 3. Working conditions

Working conditions (hours per week, SD)	All staff pharmacists (n=1,226)	Union staff pharmacists (n=103)	Nonunion staff pharmacists (n=1,113)	Pharmacists who would unionize (n=202)	Pharmacists who would not unionize (n=921)
Base hours	35.2 (11.0)	35.6 (8.6)	35.2 (11.2)	36.6 (12.1)a	34.5 (12.3)a
Compensated overtime	0.7 (2.5)	1.1 (3.1)b	0.7 (2.4)b	0.8 (2.8)	0.6 (2.2)
Uncompensated overtime	1.0 (2.8)	0.9 (2.4)	1.0 (2.8)	1.2 (3.1)	0.9 (2.2)
Full time (≥30h/wk)	79%	84%	78%	84%c	76%c
Weeks worked per year	46.7 (6.5)	46.8 (6.0)	46.7 (6.6)	46.8 (7.0)	46.5 (6.8)
Weeks vacation	2.5 (1.7)	2.7 (1.6)	2.5 (1.7)	2.5 (1.7)	2.5 (1.7)
Weeks unpaid leave	2.6 (6.6)	2.1 (5.7)	2.7 (6.9)	2.8 (7.0)	2.7 (6.9)

3.4. Compensation and benefits 

There were no statistically significant differences in mean hourly wages between union ($41.62) and nonunion ($41.80) staff pharmacists, nor were there differences in mean hourly wages between nonunion staff pharmacists who would vote to join a union ($41.68) and those who would not ($41.86). Union members reported earning significantly more overtime income than nonunion members (P=.01). There were no significant differences in any other form of additional compensation between union and nonunion members, or between those interested in joining a union and those who were not interested (see Table 4).

Table 4. Compensation

	All staff pharmacists (n=1,226)	Union staff pharmacists (n=103)	Nonunion staff pharmacists (n=1,113)	Pharmacists who would unionize (n=202)	Pharmacists who would not unionize (n=921)
Hourly wages
Mean (SD)	$41.75 ($4.77)	$41.62 ($3.16)	$41.80 ($4.86)	$41.68 ($5.70)	$41.86 ($4.76)
Median	$42.00	$41.50	$42.00	$41.80	$42.00
Annual additional compensation, mean (SD)
Overtime	$1,183 ($4,138)	$2,407a ($6,281)	$1,052a ($3,782)	$1,715 ($5,257)	$1,014 ($3,730)
Bonus	$927 ($4,093)	$482 ($1,152)	$974 ($4,275)	$636 ($1,660)	$990 ($3,168)
Profit sharing	$435 ($1,814)	$683 ($1,920)	$412 ($1,807)	$670 ($2,316)	$341 ($1,446)
Other income	$559 ($3,947)	$138 ($831)	$602 ($4,119)	$280 ($1,329)	$705 ($4,831)
Total additional compensation	$3,105 ($7,833)	$3,710 ($7,101)	$3,041 ($7,892)	$3,302 ($6,381)	$3,011 ($7,402)

Union members were significantly more likely to receive a number of benefits, including malpractice insurance and time away from work (maternity leave, nonpaid leave, sick days, paid personal days) (all P<.05) (see Table 5). Union members were also more likely to receive shift differentials, job-sharing arrangements, and discounts on personal purchases (all P<.05). But union members were less likely to receive paid association dues, paid license fees, and flexible schedules from their employers (all P<.05). When comparing nonunion staff pharmacists who would vote to join a union with those who would not, there were no differences between the groups with respect to most insurance, retirement, and time-away-from-work benefits. However, those who would vote to unionize were less likely to receive many “professional” benefits, including paid license fees, support to attend professional meetings and continuing education seminars, and tuition reimbursement (all P<.05). Those who would vote to unionize were also less likely to be offered shift differentials or flexible schedules by their employers.

Table 5. Benefits

	All staff pharmacists (n=1,226)	Union staff pharmacists (n=103)	Nonunion staff pharmacists (n=1,113)	Pharmacists who would unionize (n=202)	Pharmacists who would not unionize (n=921)
Insurance
Health—self	87	91	88	91	88
Health—spouse	79	82	81	81	81
Health—dependents	76	82	77	76	78
Dental	81	88	81	83	80
Life	80	84	81	85	80
Disability	74	77	73	77	73
Malpractice	38	50a	35	39	34
Savings
Tax sheltered plans (401k, 403b)	82	83	82	83	82
Retirement/pension plans	48	48	49	47	50
Stock purchase options	34	42	34	39	32
Time away from work
Maternity leave	58	76a	58	57	58
Nonpaid leave	52	69a	52	50	53
Paid professional leave	23	21	23	18	24
Sick leave	68	85a	68	72	67
Paid vacation	90	93	87	89	87
Paid personal days	57	86a	56	56	56
Professional
Paid association dues	14	7a	13	11	14
Paid license fee	10	2a	9	4b	10
Professional attire allowance	8	9	8	9	7
Meeting or seminar fee	26	20	27	17b	28
Tuition reimbursement	28	24	29	21b	31
Other benefits
Parking	6	6	7	4	7
Employment travel/mileage	33	27	34	29	35
Child care allowance/service	9	7	10	8	11
Shift differential	38	54a	35	31b	38
Job sharing	6	12a	5	3	6
Flexible schedule	39	31a	42	35b	43
Discounts on personal purchases	51	63a	50	52	49
Discounts on prescriptions	35	39	34	36	33
Company car	2	3	2	1	2
Expense account	3	3	3	3	2
Flexible spending account	46	45	46	42	47

All values are in percent.

3.5. Demographics 

Union staff pharmacists were younger than their nonunion counterparts (40.9 vs 44.5 years, P=.01), yet had worked for their current employers for a longer period of time (11.1s vs 7.3 years, P=.03) (see Table 6). There were no statistically significant differences between union and nonunion staff pharmacists in their sex and educational backgrounds. However, union members were significantly more likely to be nonwhite than nonunion members (26% vs 10%) (P=.01). In terms of interest in joining a union, male staff pharmacists were significantly more likely to vote to join a union than females. Twenty-two percent of nonunion male staff pharmacists would join a union, compared with 14% of females (P=.01). Thirty-nine percent of nonunion nonwhite staff pharmacists (42 of 107) would join a union if given the opportunity, compared with only 16% of whites (163 of 1,016) (P=.02).

Table 6. Demographics

	All staff pharmacists (n=1,226)	Union staff pharmacists (n=103)	Nonunion staff pharmacists (n=1,113)	Pharmacists who would unionize (n=202)	Pharmacists who would not unionize (n=921)
Years employed by current employer, mean (SD)	7.7 (7.7)	11.1 (9.3)a	7.3 (7.4)	7.5 (7.0)	7.2 (7.6)
Age in years, mean (SD)	44.2 (13.0)	40.9 (11.8)b	44.5 (13.1)	46.2 (12.4)	44.3 (13.3)
Number of years licensed, mean (SD)	19.2 (13.2)	16.6 (12.2)a	20.2 (13.7)	20.1 (13.7)	20.9 (13.3)
Sex
Male	50%	48%	50%	60%c	46%
Female	50%	52%	50%	40%c	54%
Education
BS Pharmacy	77%	70%	78%	91%d	74%
PharmD	28%	33%	27%	25%	27%
Residency/fellowship	6%	6%	6%	4%	6%
Racial background
White/Caucasian	87%	74%e	90%	79%f	93%
Nonwhite (Asian, African American, Hispanic, American Indian, others)	13%	26%e	10%	21%f	7%

3.6. Multivariate analysis 

Multiple discriminant analysis was performed to examine the ability of the study variables to explain union membership and intention to join a union. All 69 study variables (demographic, work activities, working conditions, compensation, benefits) were entered into 2 discriminant analyses (union membership, intention to join a union) using a stepwise variable entry procedure. An F value of 3.84 was required for a variable to initially enter a discriminant function, whereas subsequent F values falling below 2.71 at future steps in the procedure would result in removal of a variable from the procedure.

Twelve variables were found to be useful to explain union membership among staff pharmacists (see Table 7). Most of the variables included in this analysis were also found to be statistically significantly different for union and nonunion pharmacists in univariate analyses. The state of practice location (Illinois, Minnesota) and the chain practice setting were the most useful in explaining union membership. The 12 variables exhibited a Wilks lambda of 0.763 (meaning that 23.7% of the variance in union membership is explained by this set of variables), with an exact F of 26.84 (df₁=12, df₂=1,037, P<.001). Using the same stepwise procedure, only 5 variables were found to be useful in explaining intention to join a union among nonunionized staff pharmacists (residence in Florida, percentage of time spent in business management, availability of a tuition remission benefit, availability of a paid meeting or seminar fee benefit, and male sex). These variables accounted for 11.4% of the variance in intention to join a union (Wilks lambda 0.886, exact F=25.21, df₁=5, df₂=997, P<.001).

Table 7. Multiple discriminant analysis—stepwise variable entry procedure

Back to Article Outline

4. Discussion 

Although the union membership rate among staff pharmacists in the 6 states is relatively low, there are geographic and practice areas where pharmacy unions appear to be well established and membership rates are significantly higher. Union membership is particularly high among chain and supermarket pharmacists in Illinois, where the staff pharmacists for 2 large employers in the Chicago metropolitan area have been unionized for a number of years.¹⁵, ¹⁶

The degree of interest among nonunionized staff pharmacists in joining a union (18%) was higher than the actual unionization rate in the 6 states (8%). It is particularly interesting to note the high percentage of respondents in Florida who would vote to unionize, where 39% of nonunion staff pharmacists would join a union if given the opportunity. Written comments provided by Florida pharmacists to this survey indicate that high prescription volumes, high growth rates in both prescription volume and the number of pharmacies, and a transient pharmacist workforce resulting in high pharmacist turnover rates all contribute to conditions that lead many to consider support for unionization.¹⁷ Interestingly, Florida is a “right to work” state.¹⁸ Therefore, even in a unionized pharmacy practice setting, individual staff pharmacists can avoid both union membership and the payment of union dues and still receive the benefits of union representation. Clearly, this is a barrier to union growth. Further investigation into the reasons why Florida staff pharmacists in all practice settings appear to have such a strong desire to join a union and their relatively low union membership certainly would be merited.

Pharmacists in corporately owned community pharmacy settings (chain, supermarket, mass merchandiser) were the most likely to indicate that they would vote to join a union. Reasons for these trends may include increases in workload and their impact on working conditions, the fact that staff pharmacists are often disconnected from decisions that are made that affect their ability to practice, and the presence of existing pharmacist unions in these settings.

There were few statistically significant differences in work activities, working conditions, and wages between union and nonunion staff pharmacists. Although some may view these results as an indicator that unions are not effective, others may view them as a signal that unions are able to negotiate for working conditions and wages that are at least equal to those received by nonunion staff pharmacists. It should also be noted that in some markets where a union presence is particularly strong (eg, Illinois, Minnesota), nonunion employers may need to match the working conditions and wages of a unionized employer to attract and retain staff pharmacists.

Although there was little difference between union and nonunion staff pharmacists regarding work activities, working conditions, and wages, there were some important differences in terms of benefits. Most importantly, union pharmacists were more likely to have time away from work (maternity leave, nonpaid sick leave, sick days, paid personal days, and job sharing). Given the robust growth in wages in the pharmacy profession, perhaps gains in these benefits are more important to many pharmacists than wage-related gains.

Differences in work activities, working conditions, and benefits may help explain why some staff pharmacists may be more interested in joining a union. Respondents who spend more time dispensing, less time consulting with patients and other health care professionals, and more hours on the job were more likely to be interested in joining a union. Pharmacists who received higher levels of professional benefits (meeting or seminar fees, tuition reimbursement), shift differentials, and flexible schedules were less likely to desire to join a union. Given the aspiration that many pharmacists have today for more clinically oriented roles, it is not surprising that some pharmacists may look to union representation to help them achieve a more desirable practice environment.

The somewhat contradictory finding that union members were younger yet had been with their current employer longer merits further investigation. Possible explanations include that union pharmacists may be happier with their employers and may not wish to give up seniority within their organizations, that pharmacy unions and unionized employers negotiate a more desirable mix of wage, benefit, and working conditions, and that union members may find it more difficult to be promoted to nonunion managerial positions. Many entry-level positions in pharmacy practice are in corporately owned community pharmacy settings, which also tend to have the highest unionization rates. Literature across other occupations and industries supports the finding that employee turnover is lower in unionized workplaces.¹⁹

Resistance to unionization among some pharmacists may be explained by a belief that union membership is antithetical to the concept of professionalism. Hall's Professionalism Scale is a model that attempts to identify the characteristics of professions and professionals.²⁰, ²¹ Among the constructs of the model used to evaluate whether or not an occupation is a profession include (1) the use of professional organization as a major referent, (2) belief in public service, (3) belief in self-regulation, (4) sense of calling, and (5) belief in autonomy. In 1979, Schack and Helper modified the scale by adding a new construct (belief in continuing competence).²² One may argue that pharmacists who join a union are doing so at the risk of losing their autonomy and self-regulation to their labor union, and thus union membership may be considered “unprofessional.” Interestingly, McHugh and Bodah found that employer challenges to pharmacists' ability to perform their professional functions (eg, patient counseling, drug use evaluation) were a major factor contributing to their support for unionization.¹⁰ Moreover, in 1999 the American Pharmacists Association House of Delegates rescinded policies that discouraged pharmacists from joining unions and created policies that support pharmacists' use of collective bargaining to “support the rights of pharmacists to negotiate with their respective employers for working conditions that will foster compliance with the standards of pharmaceutical care as established by the profession.”²³, ²⁴

Limitations include the fact that although the researchers used identical data collection methods in each state, the response rates in the states spanned a wide range. The overall response rate (27%) was lower than anticipated, but not unusual for a self-administered mailed survey collecting potentially sensitive information about the respondents. Due to time and cost limitations, follow-up with nonrespondents was not performed. Lower response rates were seen in states where statewide salary surveys had not been recently performed, whereas higher response rates were seen in states where this research has occurred more frequently in the past. It is anticipated that as the researchers disseminate their results within their states, response rates to future biennial compensation surveys will improve.

With the exception of Tennessee and Florida, the states from which data were gathered were located in the Midwest. Given the practice environments inherent in these states and the variety of response rates, the responses of these pharmacists may not be representative of those in other parts of the country. The propensity for unionized pharmacists to work in specific settings (eg, large chains, supermarkets, hospitals) and in specific locations (eg, urbanized areas of Illinois and Minnesota) should also be noted. Some of the differences observed between unionized and nonunionized staff pharmacists may be inherent in differences between pharmacy practice settings and geographic locations, and not necessarily a function of the negotiating activities of a union.

Although the respondents had the opportunity to provide written comments regarding the pharmacy labor market in their area, very few made comments regarding pharmacist unionization. Although qualitative results certainly would have added to the robustness of the data collected, the primary purpose of this instrument was not to specifically evaluate pharmacist unionization. Finally, it is important to note that respondents' answers to the question regarding their desire for union representation at their workplace may differ from their vote in an actual union representation election.

Back to Article Outline

5. Conclusion 

Although the rate of union membership among staff pharmacists in the 6 states in the sample is not high, a number of staff pharmacists may be interested in joining a union, particularly in specific geographic areas and practice settings. Differences observed between union and nonunion staff pharmacists, particularly related to benefits and demographic factors, may help describe what union membership gains for their members. Differences between staff pharmacists who would join a union and those who would not may help explain why staff pharmacists would consider joining a union. As the work environment of pharmacists continues to change, staff pharmacists may continue to seek union membership as a collective voice to deal with their concerns. Pharmacists, pharmacy administrators, and researchers should continue to study, monitor, and evaluate the impact that pharmacist unionization has on their organizations and the profession.

Back to Article Outline

Acknowledgments 

The Illinois Council of Health Systems Pharmacists and Midwestern University Chicago College of Pharmacy provided both direct financial and indirect in-kind resource support.

The authors wish to acknowledge the contributions of their fellow members of the Midwest Pharmacist Workforce Consortium, who administer compensation surveys in their states on a biennial basis. Members include Lawrence “LB” Brown (University of Tennessee), William Doucette (University of Iowa), Caroline Gaither (University of Michigan), David Mott and David Kreling (University of Wisconsin), Craig Pedersen (Ohio State University), Jon Schommer and Richard Cline (University of Minnesota).

Jason J. Kopinski, PharmD (CCP Class of 2005) and Sterling Elliott, PS-II (CCP Class of 2008) served as student research assistants, and Richard Baker (Midwestern University) and Kiran Gupta (University of Minnesota) performed database maintenance.

Back to Article Outline

References 

1. Schommer JC, Pedersen CA, Doucette WR, Gaither CA, Mott DA. Community pharmacists' work activities in the United States during 2000. J Am Pharm Assoc. 2002;42:399–406
   • View In Article
2. Ukens C. Who needs you?. Drug Top. 1994;138:29–3235, 37
   • View In Article
3. Miller D. Should boards address your working conditions?. Drug Top. 2004;148:23
   • View In Article
4. Sax B. Pharmacy and technology: industry leaders meet in automation roundtable. Pharm Times. 2005;71:90;92, 94
   • View In Article
5. Schmeltzer J. Supervalu buys Jewel: sees price advantage. Chicago Tribune. January 24, 2006.
   • View In Article
6. Canham KL, Fluno AD. Consolidation of clinical services in a hospital system. Presentation at the American Society of Health-Systems Pharmacists Mid-year Clinical Meeting; 2003: 38; P-261(D).
   • View In Article
7. Hirsch BT, Macpherson DA. Union Membership and Earnings Data Book. Washington, DC: BNA Plus; 2003;
   • View In Article
8. DeBenedette V. The union label. Drug Top. 1997;141:47–48
   • View In Article
9. McHugh PP. Pharmacists' attitudes regarding quality of worklife. J Am Pharm Assoc. 1999;39:667–676
   • View In Article
10. McHugh PP, Bodah MM. Challenges to professionalism and union voting intentions: the case for pharmacists. J Labor Res. 2002;23:659–671
    • View In Article
11. Wilson CM, Hamilton CL, Murphy E. Union dynamics in nursing. J Nurs Adm. 1990;20:35–39
    • View In Article
    • MEDLINE
12. Mellor S, Holzworth RJ, Conway JM. Individual unionization decisions: a multilevel model of cost-benefit influences. Exp Psychol. 2003;50:142–154
    • View In Article
    • MEDLINE
    • CrossRef
13. Zgarrick DP, Fjortoft NF. Pharmacist compensation in Illinois: part I—overall marketplace trends. KeePosted. 2002;28:18–27
    • View In Article
14. SPSS 12.0; Chicago, IL: SPSS; 2004.
    • View In Article
15. National Pharmacists Association . Available at: http://www.npha.com/. Accessed 10.02.06
    • View In Article
16. Teamsters Local 714 Osco Pharmacists . Available at: http://www.teamsters714.org/index.php?ID=join_osco_pharmacists. Accessed 10.02.06
    • View In Article
17. Droege M, Arneson DL, Marsh WA. 2004 Florida pharmacist compensation and labor survey. Fla Pharm Today. 2005;13–15
    • View In Article
18. National Right to Work Foundation . Available at: http://www.nrtw.org/rtws.htm. Accessed 10.02.06
    • View In Article
19. Groothuis PA. Turnover: the implication of establishment size and unionization. Q J Business Econ. 1994;33:167–175
    • View In Article
20. Hall RH. Professionalism and bureaucratization. Am Sociol Rev. 1968;33:92–104
    • View In Article
    • CrossRef
21. Snizek WE. Hall's professionalism scale: an empirical reassessment. Am Sociol Rev. 1972;37:109–114
    • View In Article
    • CrossRef
22. Schack DW, Hepler CD. Modification of Hall's Professionalism Scale for use with pharmacists. Am J Pharm Educ. 1979;43:98–104
    • View In Article
23. English T. APhA House comes to agreement on collective bargaining. Pharm Today. 1999;5:1;14
    • View In Article
24. Amercian Pharmaceutical Association. APhA policy statements on employer/employee relations. American Pharmaceutical Association Policy Report, 2000.
    • View In Article